초록접수 현황
| 20F-131 | Video session발표 |
Tracheobronchoplasty using RUL Bronchial Flap in Lung Cancer originating from Tracheal Bronchus
Hyo Jun Jang 1, Seung Hyuk Nam 2, Jun Ho Lee 1, Huck Kim 1, Won Sang Chung 1
1. Department of Thoracic and Cardiovascular Surgery, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, Korea.
2. Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, Korea.
Purpose : Tracheal bronchus is an aberrant bronchus in right trachea above carina. Lung cancer originating from tracheal bronchus have been reported rarely.
Methods : A 57-year-old man had nodular opacity on chest x ray film. Chest CT showed a right lower paratracheal tumor. Bronchoscopic examination revealed lower trachea tumor and endobronchial tumor in apical segment. The bronchoscopic biopsy from the two bronchial lesions were all squamous cell carcinoma. The preoperative mediastinal lymph node biopsy and PET-CT were revealed no metastasis. The preoperative diagnosis was RUL lung cancer invading both tracheal and apical segment(cT4N0M0). The preoperative surgical plan was to RUL lobectomy with tracheobronchoplasty. Superior vena cava resection and reconstruction was considered if needed.
Results : Veno-veno extracorporeal membrane oxygenation was performed intraoperatively. In operative finding, the supernumerary trachea bronchus was founded instead of paratracheal tumor. Initially, the tracheal bronchus was resected at the origin. After 3 times additional trachea resection, the margin was free from tumor. The defect of trachea was reconstructed with RUL bronchus flap. At the 20 days after surgery, the patient was discharged because of prolonged air leakage. The pathologic stage was mpT1bN0M0
Conclusion : The lung cancer originated from tracheal bronchus was a rare case, however it should be kept in mind. In the selected case, tracheobronchoplasty using RUL bronchial flap might be an alternative surgical option to reduce anastomotic tension.
Methods : A 57-year-old man had nodular opacity on chest x ray film. Chest CT showed a right lower paratracheal tumor. Bronchoscopic examination revealed lower trachea tumor and endobronchial tumor in apical segment. The bronchoscopic biopsy from the two bronchial lesions were all squamous cell carcinoma. The preoperative mediastinal lymph node biopsy and PET-CT were revealed no metastasis. The preoperative diagnosis was RUL lung cancer invading both tracheal and apical segment(cT4N0M0). The preoperative surgical plan was to RUL lobectomy with tracheobronchoplasty. Superior vena cava resection and reconstruction was considered if needed.
Results : Veno-veno extracorporeal membrane oxygenation was performed intraoperatively. In operative finding, the supernumerary trachea bronchus was founded instead of paratracheal tumor. Initially, the tracheal bronchus was resected at the origin. After 3 times additional trachea resection, the margin was free from tumor. The defect of trachea was reconstructed with RUL bronchus flap. At the 20 days after surgery, the patient was discharged because of prolonged air leakage. The pathologic stage was mpT1bN0M0
Conclusion : The lung cancer originated from tracheal bronchus was a rare case, however it should be kept in mind. In the selected case, tracheobronchoplasty using RUL bronchial flap might be an alternative surgical option to reduce anastomotic tension.
책임저자: Hyo Jun Jang
Department of Thoracic and Cardiovascular Surgery, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, Korea.
발표자: Hyo Jun Jang, E-mail : rgo38@naver.com